PTSD Post-Traumatic Stress Disorder

By: Maddie Lynch (leader), Willie Kimball and Nathaniel Matsuura

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PTSD Overview

an anxiety disorder that affects hundreds of thousands of people who have been exposed to violent events such as rape, domestic violence, child abuse, war, accidents or any traumatic event.

Symptoms
· Intrusive symptoms:
o sudden, vivid memories accompanied by painful emotions -> flashback
o Triggered by sights, sounds or smells
o For children intrusive symptoms often appear in the form of nightmares, and feeling a “re-experience”
· Symptoms of avoidance:
o shows diminished emotions
o completes only routine, mechanical activities
o avoids close relationships to family and friends.
o The victim tries to avoid anything having to do with the traumatic event. Depression or showing no emotion at all is common for PTSD victims.
· Hyper arousal symptoms:
o Victims may have trouble concentrating or remembering things
o may develop insomnia.
o Irritability and sudden outburst of emotion for no real reason
o Symptoms to the highest degree



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PTSD with Children:
*There are many people and numerous children in Afghanistan suffering from PTSD because they witness bombing, abuse and just poor living conditions daily, but there are not enough doctors to handle the problem. The Taliban control the lives of the Afghanis and the tourture and abuse leads to PTSD symptoms all over this country.

Common causes for children:
witnessing a traumatic event, learning about a traumatic event, experiencing violent death of a family member or peer, or experience of sexual abuse

Common Symptoms for children:
reoccuring memories of the past/flashbacks, frightening dreams, difficulty falling and staying asleep, panic or anxiety attacks, difficulty concentrating, changes in mood, showing extreme emotions or little or no emotion, guilt or shame and selfblame, and even drug abuse

PTSD with Sohrab:
Sohrab experiences many things during his life that could cause him to show signs of PTSD, these include:
  • Afghanistan at war
    • Taliban ruling with a strong hand, striking fear into the afghani people. Forces everyone to be prepared for attack at any time.
  • Death of Hassan and Sanaubar
    • Sohrab sees his parents being executed in front of his own home.
  • Living in an Orphanage
    • Abused by Taliban officials, little food and poor shelter.
    • Please, Please, no!. Im scared of that place. They‘ll hurt me! I don’t want to go.” “No its not. Not that place. God, oh God. Please, no!” (341-342)
  • Assef's possible sexual abuse of Sohrab
    • Sohrab wearing makeup when amir finds him, Assef being inappropriate when addressing him.
    • "What do you want to do with him?" he said. Then a coy smile "Or to him." That's disgusting" I said. "How would you know? Have you tried it?" (285)
  • Witnessing Amir and Assef's grusome fight
    • Sees Amir almost get beaten to death.
    • The tears broke free. Sohrab shook his head. “Please, agha, Stop.” (290)
      Shoots Assef in the eye, causing him a great deal of pain
    • fears his life is in danger with the Taliban and Assef (who is only wounded) will be after him and Amir

+ These experiences with Sohrab lead to these symptoms we see in the book:
  • Loss of Interest
    • Sohrab is not as excited as Amir at the end flying the kite
    • Also he barely listens when Amir tells him he won't have to go to an orphanage, even though it is great news
  • Extreme or Sudden Emotional reactions
    • When Amir mentions an orphanage again, Sohrab responds with "his voice breaking and tears pooling in his eyes", "No, no please. You promised you'd never put me in one of those places Amir agha" page 341
  • Problems Sleeping
    • Amir wakes to find Sohrab out of bed and finally finds him outside the mosque
  • Selfblame and Guilt
    • Sohrab is glad his parents are not around anymore because he is embarrassed adn thinks they would be disappointed in their son
    • page 319 "Sometimes I am glad they are not here anymore because I don't want them to see me... I'm so dirty. So dirty and full of sin"
  • Avoiding thinking or talking about his past life
    • Sohrab never mentions life at the orphanage or any detail with Assef
  • Cannot Maintain Close Relationships
    • Although Amir has tried to show that Sohrab can trust him, Sohrab isolates himself with contact from others.
    • page 341 "So I left the room and went looking for another hotel, unaware that almost a year would pass before I would hear Sohrab speak another word"
  • Attempted Suicide
  • Sohrab's Silence
    • Sohrab’s violent and traumatizing past led him to suffer many symptoms of PTSD. At the end of the book, we see Sohrab’s silence as he pulls himself away from the rest of the world. Amir recalls “receiving no answer” and being “met again by silence” when attempting to help Sohrab. By offering to bring Sohrab to America, Amir brings a little bit of hope to Sohrab’s life of misery but Amir’s promise was broken when he mentions returning to the orphanage. Here, all of Sohrab’s depression returns and he stops talking for almost a straight year. Amir knows there is nothing he can do when he hears Sohrab repeat that he is just “tired of everything”.

PTSD and Growing issue:

The number of citizens in Afghanistan who suffer from PTSD is only increasing. Without any real help given in Afghanistan and the continued attacks orchestrated by the Taliban, victims continue to increase. These attacks and the government's inability to respond will only lead to more victims of PTSD
Although these are not direct stories from victims they are what lay the foundation for an infinite number of Afghanistan citizens with PTSD
  • Lack of govenment involvement
    • The current government in Afghanistan does not even know its own population est.(26-30 Million) an estimate of possibly 20%
    • When Sohrab was trying to get out of the country they needed "Death Certificates" which although his parents were certainly deceased could not be produced. The lack of a system that works will create who will only injure sufferers of PTSD more. If a child like Sohrab wanted to get help he would most likely be denied on the grounds that his parents are still alive, atleast according to record.
  • Sheer scale of Taliban's
    • In little more than three months, in Kabul alone, devastating suicide attacks have killed around 100 people. About 300 people have been injured.
    • Across the country, and in a rising trend this year, more and more civilians are becoming collateral damage in the escalating war between the Taliban and Afghan government forces, backed by more than 100,000 international troops.


Afghan victims of Taliban violence suffer in silence
Afghan victims of Taliban violence suffer in silence

The son of Abdul Wakil Dilawari, who was killed during a suicide attack against Italian soldiers in Kabul,holds up a photo of his father
Account from one Afghanistan family
"Where is Daddy?" three-year-old Weda asks her mother Yalda every day.
Abdul Wakil Dilawari - Yalda's husband and father of eight children aged three to 13 - was killed on September 17 when an explosives-packed car rammed into a Nato military convoy in front of his tiny shop on a busy highway.
The blast, heard across Kabul, was so big it left a massive crater in the road and killed six Italian soldiers in heavily armoured military vehicles.
Ten Afghans were killed on the spot - a wide stretch of road lined on one side by a row of ramshackle buildings housing shops, pharmacies and doctors' surgeries.
Dilawari, a 37-year-old former soldier, rented out catering supplies for weddings, funerals and other functions.
When Yalda, 31, heard the blast around lunchtime, she and her mother-in-law, 55-year-old Shah Jan, screamed as they ran from their home on the hill towards the carnage, knowing their lives had just changed forever.
LIke Sohrab, with no official recognition of their existence - let alone a law that protects the rights of the disabled - people such as Yalda and her fatherless family have little hope of official support.
The International Committee of the Red Cross calls them "invisible victims" because they slip through the bureaucratic nets, largely left to fend for themselves economically, emotionally and psychologically.

After examining their story, which is only one of a large number of victims it is easy to see how constant the death occurs. Even if their family did not see it; its only a matter of time before something truly traumatizing occurs. Clearly relating to the causes of PTSD mentioned above.

Where will Sohrab be next?


Many victims of PTSD may be able to recover quickly with the help of family, friends or a pastor/rabbi. In Sohrab;s case, he will need more professional help to recover from he psycholoigical damage to even consider living a normal life in the future. Common types of treatment for PTSD victims include:
  • Cognitive-behavioral therapy: a therapist gradually helps understand and change the way a victim thinks about their trauma
  • Eye movement desensitization and reprocessing therapy: frees the brain of trauma thoughts & things that are reminding of the trauma
  • Group/Family Therapy: helps your loved ones understand and be able to communicate better
  • Medications: will not treat the cause but can help with side effects
Treatments may last only a few months for some victims but Sohrab may need years or even a whole lifetime to face his fears or even address his past with others.

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http://www.telegraph.co.uk/expat/expatnews/6634931/Afghan-victims-of-Taliban-violence-suffer-in-silence.html